Point of service billing and records system

ABSTRACT

A billing and records system software application that places responsibility for billing and coding accuracy upon the provider of services and is used on a front-end computer which allows the provider to update, edit, and input data. The front-end computer is linked to a back-end computer. The back-end computer program stores the necessary databases for use on the front-end computer. The reference databases have all of the current coding required for the provider. The back-end computer also contains a linkage component and a billing program which uses data from the front-end computer to prepare a bill for the encounter.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to a billing and records system.More particularly, though not exclusively, the present invention relatesto a code-driven computerized system for health care billing that placesthe responsibility for billing on the health care provider at the pointof service. The present invention includes variations for other serviceindustries in which it is desirable to place primary responsibility forbilling and records keeping on the service provider. Other industriesinclude, but are not limited to the fields of law, accounting,dentistry, architecture, and any other service-type industry whereclients demand service providers be accountable for their time andservices.

2. Problems in the Art

In 1966, the American Medical Association developed a system it callsCurrent Procedural Terminology (CPT). The CPT system is used by doctorsand other health care providers to ensure uniformity in the descriptionof services performed through the use of a common set of codes anddescriptors. Unfortunately, the CPT is updated every year and in theyear 2000 is expected to utilize 7,755 codes and descriptors. Suchconstant updating of so many codes requires care providers to spendcountless hours ensuring the proper codes for services provided arebeing utilized correctly. With the passage of the Medicare CatastrophicCoverage Act of 1988, it became a mandatory requirement to usediagnostic coding of the International Classification of Diseases,9^(th) Revision, Clinical Modification, (ICD-9CM) published by thePractice Management Information Corporation with a new revisionavailable approximately September 15^(th) of each year. Proper coding isthe essential component of billing systems in order to satisfy the needsof clients relative to insurance companies, health maintenanceorganizations, and federal government programs such as Medicare andMedicaid.

Currently, there are multiple medical billing systems in place in whicha care provider, such as a doctor, nurse, or allied health careprovider, must manually enter coded patient care data on paper sheetsprior to placement into a computer system. A billing clerk or othernon-care providing personnel is then required to convert codes into apatient specific bill. This procedure allows for too many errors andplaces the ultimate responsibility for proper billing of clients onclerks and other personnel instead of upon the provider of services. Asthe health care provider is legally responsible for their submittedcodes, it is desirable to facilitate the proper coding and billing forthe person performing the services, i.e. the care provider.

Prior art systems which have attempted to correct this situation haveallowed care providers to input patient specific coding in various ways.One prior art method of properly coding patient services was to use apreprinted super bill, such as the DocuScan®. A super bill, as commonlyknown in the art, allows the care provider to simply select theappropriate codes for the services performed via a Scantron® type sheet.However, due to the great number of codes, the super bill only containspre-selected codes. Any additional or supplemental codes must be enteredand selected manually by the care provider or an assistant and manuallytransferred into the billing system. Further, the super bill requiresthe care provider to take time filling in circular indicators andfinding exactly what codes should be marked for the services performed.Once completed by the care provider, the super bill is then submitted toother personnel and a patient specific bill is generated.

Still other prior art systems allow doctors to use a remote terminal andbatch in, or download from a main terminal, all of the patient recordsfor patients to be seen during the day. Upon download, the care providercan then input which services were performed for the patients on theremote terminal. At the end of the day, the care provider must thenbatch out, or upload to the main terminal, all the patient records inone action. Upon receiving the patient records, including the servicesperformed, the main terminal can then be used to generate individualpatient bills. This prior art system does not allow for the real-timegeneration of an individual bill or correction of erroneously selectedcodes prior to the patient's departure from the care provider's office.A further problem with such a prior art systems has been the inabilityto edit a patient's data once that data has been entered and before thedata is transmitted or to input a new patient into the system at thepoint of care via the remote computer.

Still further yet, such systems do not allow the care provider to easilycustomize the diagnosis and procedure code screens with those codes mostfrequently used in the care provider's particular practice or field ofspecialty; such customization would require additional programming withgreat cost in terms of time and money. Nor do the prior art systemspermit the care provider to research on-line for a particular code.

As on-line, or Internet based health-care information is becoming moreand more prevalent, and more and more patients are on-line, it isdesirable to have a system which is capable of having an on-linepresence. Currently, WebMD.com provides information on physicians,diseases, and other medically related fields. However, the site does notallow patients to review their records or billing on-line. Further, thesite does not allow care providers to provide such information.

Finally, remote computer systems are currently limited to laptop ordesktop units which are then hardwired into the walls at the point ofcare and thereby wired to the main terminal. This prevents the careprovider from entering data from any location other than where thecomputer has been placed. It is therefore desirable to provide awireless, lightweight remote terminal system which allows the careprovider to freely roam about and enter data anywhere at the point ofcare. It is further desirable to be able to access the host system evenwhen out of the care provider's home office. In short, these prior artsystems lack the functions and flexibility to be of significantassistance to the care provider. It is therefore desirable to have asystem which overcomes the deficiencies found in the prior art, solvingthe aforementioned problems.

There is therefore a need to have a computer system that placesresponsibility for individual patient or client information, servicesprovided, and billing records with the service provider at the point ofservice and allows the service provider to provide the patient or clientwith a bill upon the patient's or client's departure. In a medicalapplication, there is a need to have a code driven computer system whichaccomplishes the above.

FEATURES OF THE INVENTION

A general feature of the present invention is the provision of a billingand records system which overcomes the problems found in the prior art.

A further feature of the present invention is the provision of a billingand records system which is code driven.

Another feature of the present invention is the provision of a computerbilling and records system which places responsibility for billing andrecord keeping on the service provider.

A further feature of the present invention is the provision of awireless computer billing and records system.

A still further feature of the present invention is the provision of abilling and records computer system that allows the service provider toinput data at the point of service.

A yet further feature of the present invention is the provision of abilling and records computer system that allows the service provider toinput data through an integral on-screen keyboard, dedicated to theindividual screens as necessary and useful.

Another feature of the present invention is the provision of a billingand records computer system which allows a service provider to generatea patient's or client's bill prior to the patient's or client'sdeparture.

A still further feature of the present invention is the provision of abilling and records computer system that allows a service provider todownload specified patient or client data to and from a back-endcomputer.

An additional feature of the present invention is the provision ofselected lateral communication from one front-end system to anotherdistinct front-end system.

An still further feature of the present invention is the provision oflateral communication from one terminal to another via a wirelesslinkage.

An additional feature of the present invention is the provision oflateral communication from one terminal to another via a hard wirelinkage.

Another feature of the present invention is the provision of a computerbilling and records system that uses a graphical user interface tointeract with the service provider to provide a means for accessingpatient or client record and billing information at the point ofservice.

An additional feature of the present invention is the provision of abilling and records computer system having time based or service basedcode screens which may be easily customized by the service provider.

A still further feature of the present invention is the provision of abilling and records computer system having diagnosis and procedure codescreens easily customized by the service provider.

A yet further feature of the present invention is the provision of abilling and records computer system that permits a service provider tosearch on-line, by code number or code description, to identify andselect a particular code.

A still further feature of the present invention is the provision of abilling and records computer system which provides access to serviceproviders and patients or clients via the Internet.

These, as well as other features and advantages of the presentinvention, will become apparent from the following specification andclaims.

SUMMARY OF THE INVENTION

The present invention generally comprises a computer billing and recordssystem. In a preferred medical embodiment, the present inventionincludes a software application that is CPT and ICD-9CM code-driven andplaces responsibility for patient billing and record keeping on the careprovider at the point of care. A software application residing on aremote computer is included which provides a graphical user interfacefor the care provider. The software application allows the care providerto input and edit individual patient data from the remote computer.Further, the software application allows the care provider to select theappropriate coding and allows the care provider to update the codesappropriately.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a pictorial representation of the network connectivity set-upof the preferred embodiment of the present invention.

FIGS. 2A and 2B (collectively referred to as “FIG. 2”) are a flow chartof the back-end of the present invention.

FIGS. 3A, 3B, 3C, and 3D (collectively referred to as “FIG. 3”) are aflow chart of the front-end of the present invention.

FIG. 4 is a pictorial representation of the Splash screen.

FIG. 5 is a pictorial representation of the Log On screen.

FIG. 6 is a pictorial representation of the Edit Practice Data screen.

FIG. 7 is a pictorial representation of the Main Menu screen.

FIG. 8 is a pictorial representation of the Patient Selection screen.

FIG. 9 is a pictorial representation of the Facility Selection screen.

FIG. 10 is a pictorial representation of the Add A Patient screen.

FIG. 11 is a pictorial representation of the Edit A Patient screen.

FIG. 12 is a pictorial representation of the Patient Procedure andDiagnosis screen.

FIG. 13 is a pictorial representation of the Diagnosis Codes screen.

FIG. 14 is a pictorial representation of the Procedure Search Optionscreen.

FIG. 15 is a pictorial representation of the Diagnosis Codes Searchscreen.

FIG. 16 is a pictorial representation of the Ailment screen.

FIG. 17 is a pictorial representation of the Referring Provider Listscreen.

FIG. 18 is a pictorial representation of the Note screen.

FIG. 19 is a pictorial representation of the Modifier Option screen.

FIG. 20 is a pictorial representation of the Units Option screen.

FIG. 21 is a pictorial representation of the Summary screen.

FIG. 22 is a pictorial representation of the Import Data screen.

FIG. 23 is a pictorial representation of the Password Screen.

FIG. 24 is a pictorial representation of the Tools and Utilities screen.

FIG. 25 is a pictorial representation of the Full Tools and Utilitiesscreen.

FIG. 26 is a pictorial representation of the View Practice Data screen.

FIG. 27 is a pictorial representation of the Color Preference screen.

FIG. 28 is a pictorial representation of the Setup screen.

FIG. 29 is a pictorial representation of the Procedure Code Setupscreen.

FIG. 30 is a pictorial representation of the Diagnosis Code Setupscreen.

FIG. 31 is a pictorial representation of the Abort Program screen.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S)

The present invention will be described as it applies to its preferredmedical embodiment. It is not intended that the present invention belimited to the described embodiment. It is intended that the inventioncover all modifications and alternatives which may be included withinthe spirit and scope of the invention.

As shown in FIG. 1, the billing and records system 10 of the presentinvention is a front-end-back-end system, with an open standards-basedsoftware architecture as is commonly known in the art. A new trend insuch architecture is “multi-tiered solutions.” A tier is simply a layer,usually consisting of a particular piece of software. For instance, in atypical front-end/back-end relationship, the front-end is one tier andthe back-end is another tier. The front-end performs user interfaceservices such as entering, editing, validating, and displayinginformation on the front-end computer 14 as shown in FIG. 1. The userinterface preferred for use by the care provider is a graphical userinterface, running for example in Microsoft Windows 98® via MicrosoftVisual Basic 6.0, that interacts with the care provider as thefront-end.

The front-end computer 14 is preferably a pen based computer such as theFujitsu Model Point 1600, including a radio frequency based Proximconnection system. The use of a wireless, pen based computer allows acare provider to enter all necessary data from the point of care withminimal equipment interference. The back-end computer 12 is preferably aHewlett Packard computer running a UNIX operating system, though anyoperating system compatible with the front-end computer 14 isacceptable. Both the front-end computer 14 and the back-end computer 12are preferably Internet capable. Internet capable means each computer isconnected to and may be accessed from the Internet 16. Connection to theInternet 16 is accomplished using Transfer Control Protocol/InternetProtocol (TCP/IP), and an internet service provider such as U.S. West,Iowa Network Services, or any other provider.

The front-end computer 14 is linked to the back-end computer 12 througheither the Internet 16 or a direct linkage. This linkage may be either awired or wireless linkage, such as the Proxim connection systemmentioned above. Further, any other computer 18 may be connected to oraccessed from either the front-end computer 14 or the back-end computer12 through the Internet 16.

On a web page, not shown, information about healthcare related issues ispresented along with an access area in which patients would be able toenter an access code and user identification so as to access and viewtheir records and billing information. The care provider would have aseparate access code and user identification which would allow the careprovider to provide, edit, review, and download patient records andbilling information. Should any questions arise, patients are able toclick on the e-mail address provided to ask a care provider to addresstheir concerns. The web page is preferably created in hyper text markuplanguage (HTML).

To provide patient records and billing information over the Internet 16requires a high level of security in order to ensure no access is givento non-patients. This form of Internet security can be provided for byimplementing the measures as stated in U.S. Pat. No. 5,898,830 toWesinger, Jr., et al., hereby incorporated by reference. Of course, thefront-end computer 14 may also be internet capable.

As shown in FIG. 2, a linking computer program 300 is located on theback-end computer 12. The linking computer program 300 uses a patientdatabase to create a patient work file on the back-end computer 12. Thepatient work file is a text file which contains a list of all patients,and their necessary accompanying records, to be seen for a specific daysuch as the current day.

The linking computer program 300 initially presents the care provider,system administrator, or user, with a main menu 302. The main menu 302screen, presents the care provider with several options, including aport for program option 304, a summary report option 306, a detailreport option 308, a enter no shows/cancels option 310, a daily archivemaintenance option 312, a control file maintenance option 314, a createmodifier code file option 316, a create service code file option 318, acreate diagnosis code file option 320, a create referring provider fileoption 322, a create facility code file option 324, a create patientencounters option 328 and a create program files option 326.

The control file maintenance option 314 governs information regardingthe front-end program described below and its interaction with theback-end computer 12. The control file maintenance option 314 segregatesthe location of the front-end program data files, in relationship to theback-end system.

A reference database may be maintained on the back-end computer 12 orany other system 18 to which the back-end computer 12 may connect eitherthrough hard wire linkage or wireless linkage. The reference databasemay be accessed from or over the Internet 16. The reference data basecontains all procedure codes, modifier codes and diagnosis codes needed,as well as a complete patient/client list. The present invention usesand obtains the latest electronic versions of the American MedicalAssociations CPT as well as International Classification of Disease9^(th) Edition (ICD-9CM) terminology. These codes may be downloaded fromthe Internet 16 or from disks. Additionally, if necessary, these codesmay be input by a system administrator.

Using the reference database, the create modifier code files option 316creates the modifier code file for export to the front-end computer 14containing all modifier codes residing on the back-end system. Againusing the reference database, the create service code file option 318creates a file for export to the front-end computer 14 containing allprocedure or service codes, residing on the back-end system. Using thereference database again, the create diagnosis code file option 320creates a file for export to the front-end computer 14 containing new orupdated diagnosis codes.

The create referring provider file option 322 creates a file for exportto the front-end computer 14 containing all referring providerinformation and codes, residing on the back-end system. The createfacility code file 324 creates a file for export to the front-endcomputer 14 containing all current facility information residing on theback-end system.

The create program code file option 326 creates a file for export to thefront-end computer 14 containing all of the current information listedabove for transmission in batch mode. The use of create program codefile option 326 alleviates the need to run each option separately.

The create patient encounters option 328 creates a patient work filewhich contains all of the patients with their corresponding appointmenttimes for the current day. The patient work file created by the patientencounters option incorporates the current information compiled by thecreate program code file option 326 or any of the separately runoptions. The current information is incorporated with each patient'sinformation such that should the care provider choose, the care providermay select only one patient at a time and still be presented with all ofthe current information at the time of the patient's appointment.

The daily archive maintenance option 312 moves the contents of thepatient work file to a file entitled using the work file name as theprefix and the current day's date as the suffix. Th daily archivemaintenance option 312 clears out and stores the previous day's workfile.

The summary report option 306 provides the care provider with a summaryreport of general data regarding the procedure charges which may beviewed and/or printed. The detail report option 306 provides the careprovider with a printed detailed report regarding the procedure chargeswith related diagnosis codes for the day which may be viewed andprinted.

The enter no shows/cancels option 310 updates the patient work file forthose patients that have not shown up for their appointments or havecanceled their appointments. The updated work file is then transmittedto the front-end computer 14 via the program link 106 described below,or transmitted from the front-end system to the back-end system via theprogram link.

The port for program option 304 opens the program link 106 describedbelow. All files, including either the batch file created by the createprogram code file option 326 or the individual files by the createoptions above, the updated or current patient work file are transmittedto the front-end computer 14 via the program link 106 as describedbelow.

Further, the back-end computer 12 contains a billing program capable ofreceiving individual patient data and forming a Health Care FinancingAdministration (HCFA) Form 1500 statement for billing based on servicesperformed and treatments given as shown in the patient work file. Usingthe appropriate information from the patient work file including thecodes representing the services performed, the billing programdetermines the proper amount of charges due for services rendered oneach particular visit for each particular patient. Additionally, thebilling program may be adapted to transfer patient data from the patientwork file to electronic versions of other insurance and governmentalforms.

The core of the billing and records keeping system 10 of the presentinvention is a computer program which makes it possible to place all theresponsibility for billing and record keeping on the care provider whileensuring the care provider has the latest up-to-date codes availablefrom the back-end computer 12 as described above.

The graphical user interface and object-logic tiers of the presentinvention are programmed for a front-end computer, preferably theFujitsu Model 1600 running on a Microsoft Windows 98® platform. Thepreferred programming languages are Microsoft Visual Basic and C+.

FIG. 3 shows a flowchart of a computer program which resides on thefront-end computer 14 of FIG. 1. The computer program is capable ofcommunicating with the back-end computer 12, and is therefore designedfor use over networks or the Internet. Communication preferably takesplace over a Proxim radio frequency based system, but may also use hardwired connections, such as telephone lines or Ethernet lines, or a radiofrequency modem and accompanying antenna and system. The back-endcomputer 12 may be a single computer or other system, including existinghospital information support systems, or remote Internet access servers.

As shown in FIG. 3, upon start up, a care provider is presented with asplash screen 20, shown in FIG. 4, which welcomes the care provider tothe system 10 and gives general information regarding the softwarelicensing and title. After this brief welcome, the logon screen 22,shown in FIG. 5, appears. The logon screen 22 requires the care providerto enter a proper user identification 24 and password 26 in theappropriate text fields shown in FIG. 5, and select the OK option 28push button. At initial startup, a general user identification 24 andpassword 26 may be used. As is further shown in FIG. 5, an on-screenkeyboard 200 may be used to enter in the identification 24 and password26. The on-screen keyboard is integral to the screen and remains screenspecific. Additionally, software capable of recognizing handwriting maybe installed onto the front-end computer 14 allowing the care providerto simply write the identification 24 and password 26 into theappropriate text fields via pen input.

The identification 24 and password 26 may be changed to a care providerspecified identification 24 and password 26 through the Edit PracticeData Screen of the Tools and Utilities Sub Menu, shown in FIG. 6, asdiscussed further below. This ensures patient data will only be accessedby authorized personnel, further ensuring patient record privacy. Shouldthe care provider fail to enter a proper identification 24 and password26 or choose to cancel the logon operation by selecting the canceloption 30, such care provider will be directed to the exit 32 of thecomputer program.

Once access has been obtained, the main menu 34 of the computer programis displayed as shown in FIG. 7. The main menu 34 of the computerprogram consists of a screen which presents the care provider withseveral options. From the main menu 34, the care provider may choose anoption, by simply pressing the pen of the pen based computer on theappropriate push button on the screen representing that option. Theoptions available on the main menu 34 include an option for openingtoday's clinic database 36, an option for evaluating patient summaries38, an option to import data 40 from the back-end computer 12, a toolsand utilities option 42, an option to evaluate the program source data44, and a log off option 46.

As shown in FIG. 8, upon pressing the push button for the option foropening today's clinic database 36, the patient selection screen 48 isdisplayed, showing a list of the current day's patients compiled fromthe transmitted patient work file discussed above, with the firstpatient highlighted in the patient list box 49 along with the currentplace of service for that patient. Along with the name of the patient,the patient's date of birth, provider, encounter number, the date ofcurrent encounter, the time for the appointment, the back system accountnumber, the action status and the result of actions taken status isdisplayed.

The patient selection screen 48 allows the care provider to select whichpatient is being cared for. Selection is accomplished by pushing on thepatient name with the pen and thereby highlighting the patient. Once thecorrect patient has been highlighted, the OK option 50 push button isselected. If the care provider no longer wishes to select any patient,the care provider may return to the main menu 34 by selecting the canceloption 52 push button.

The patient selection screen 48 further allows the care provider to editthe location at which services are performed by selecting the changeplace of service option 62 push button. Selecting the change place ofservice option 62 directs the care provider to the Facility Selectionscreen 78, as shown in FIG. 9. The Facility Selection screen 78 displaysa place of service box 80 and a facility list box 82. By highlightingthe place of service and the facility of service, no facility selectionneed be made for the care provider's office, and then selecting the OKoption 84 push button, the care provider can change the place ofservice. Clicking the cancel option 88 push button will keep the currentplace of service information. A help option 90 push button can beselected and will display helpful information on the screen. Selectionof the place of service allows the care provider to quickly indicatewhether services are to be performed as an in-patient, out-patient,clinic or other service.

As shown, the select a patient screen of FIG. 8 further allows the careprovider to add, as shown in FIG. 10, or edit, as shown in FIG. 11,individual patient data. Therefore, the responsibility for patientrecord keeping falls on the care provider rather than a non-careproviding person who must interpret the care provider's notes and/ordictation to arrive at the data in question.

The care provider may add patient profiles for the current day'sprocessing. From the patient selection screen, shown in FIG. 8, the careprovider can select the add a patient option 54. This directs the careprovider to the add a patient option 54 screen, as shown in FIG. 10.

The add a patient option 54 screen includes several text boxes whichallow the care provider to input data concerning the patient, includingthe account number, the appointment time, the patient's last name, thepatient's first name, the patient's middle initial, the patient's dateof birth, and the care provider's provider number. Other information canbe added by adding additional text boxes and customizing the add apatient option 54 screen to include desired information relevant to thetype of services provided.

Here again the care provider may use the on-screen keyboard 200 or thepen input to add an individual patient profile. Selecting the OK option94 push button enters the patient information. Upon selecting the OKoption 94, the patient profile is immediately available for use with therest of the billing and records system 10. Selecting the cancel option96 push button will return the care provider to the select a patientscreen 48. Additionally, a help option 98 push button is provided toprovide helpful information to the care provider upon request.

Similar to the add a patient option 54 is the edit a patient option 56.Unlike the add a patient option 54, the edit a patient option 56 screen,shown in FIG. 11, presents the care provider with text boxes alreadycompleted with patient information of the highlighted patient to beedited. This patient information may be edited through the use of eitherthe pen or the on-screen keyboard 200. The OK option 100, the canceloption 102, and the help option 104 push buttons work similar to thosein the add a patient option 54.

The patient selection screen 48 also includes a send/receive option 58.After a patient has been cared for, the patient data is ported to theback system through the program link, with a result code shown in FIG. 8indicating successful porting to the back-end computer or an errormessage. The services performed action code appears on the select apatient screen 48 as an asterisk in the action column of the patientlist before sending the data to the back-end system. Once the updatedpatient data has been sent, an “S” is shown in the Action Section. Oncedata has been received by the back-end system 12, the back-end system 12transmits data to the front-end system 14 indicating the latest data hasbeen received, indicating the result of successful transmission of codedata with an “x” in the result column and, thereby changing the actioncode to an “S” as shown in FIG. 8.

The send/receive option 58 screen uses the program link 106 to send andreceive patient or coding data between a front-end computer 14 and aback-end computer 12. Simultaneously, all patient data with an asteriskaction code is transmitted. This allows for single batch or multiplebatch transfer of patient data capabilities. By selecting the receivedata option 164, data for new patients to be seen, cancellations, noshows, updates, or similar information is transmitted from the back-endcomputer 12 to the front-end computer 14 with each activation of theSend/Receive link. This capability to send and receive individualpatient data allows the care provider to properly bill a patient uponthe patient's departure from the care provider's office and isresponsive to the burdens placed upon the typical operations of aclinic, namely add-on patients, such as “walk-ins” or “work-ins.”

All transmission between the front-end computer 14 and the back-endcomputer 12 or vice-versa occur via the program link 106 as describedbelow. Such importing/exporting of data may take place immediately,updating the care provider while viewing the patient selection screen32.

The patient selection screen 48 further allows the care provider to askfor help by selecting the help option 60 push button. Help is providedin all of its applications in the present invention internally, via thefront-end computer 14, or the Internet 16 to which the front-endcomputer 14 are connected. Help is routed through the program link 106if necessary.

Preferably, the front-end computer 14 and back-end computer 12 arelinked wirelessly via the program link 106. The program link 106 ispreferably a wireless linkage using a radio frequency (RF) local areanetwork (LAN) such as Proxim or BreezeCom. Other forms of communicationbetween the front-end computer 14 and the back-end computer 12 may beused such as cellular, time modulated ultra wide band radio frequency,infrared, or any type of conventional hard wiring which is commonlyknown in the art.

Once a patient has been selected from the patient selection screen 48,the care provider is directed towards the Patient Procedure andDiagnosis Codes 104 screen as shown in FIG. 12. From here, the careprovider can select the proper procedure and diagnosis codes from theAmerican Medical Associations CPT. The patient procedures codes and adescription of the procedure appear at the bottom of the screen shown inFIG. 12. Upon selecting the appropriate procedure code, the careprovider is directed to the diagnosis screen 106 as shown in FIG. 13.

If the proper procedure code is not shown, the care provider may selectthe procedure search option 132. Clicking on the procedure search option132 push button directs the care provider to the procedure search option132 screen as shown in FIG. 14. Here the care provider can search bynumber or by description for the procedures not previously found usingeither the pen or the on-screen keyboard 200. Selecting the OK option134, or the cancel option 136 returns the care provider back to thepatient procedures and diagnosis codes screen 104 with or without theselected codes respectively. The care provider may also select a helpoption 138 which will present the care provider with helpfulinformation.

In the diagnosis screen 106, the care provider can select the properdiagnosis code(s). Up to four diagnosis codes can be selected, however,if more are required by the Health Care Financing Administration (HCFA)in the future, this number can easily be expanded. The selecteddiagnosis code appears in the upper left corner of the diagnosis screen106 as shown in FIG. 13 and the order of codes may be changed byhighlighting the desired code and then moving the highlighted codeeither up or down, to the top or to the bottom by selecting theappropriate push button. Additionally, either the highlighted code orall of the codes selected may be deleted by pushing the appropriate pushbutton. When the care provider is done selecting diagnosis codes, the OKoption 108 push button is selected directing the care provider back tothe Patient Procedure and Diagnosis Codes Screen 104. Additionally, ifthe care provider does not wish to select a diagnosis code at this time,the care provider may select the cancel option 110 push button, therebyreturning the care provider to the Patient Procedure and Diagnosis CodesScreen 104. Upon pressing the cancel option push button, the careprovider will be prompted to determine whether the intention to leavethe screen without updating is correct. Only upon affirmation will thecare provider be returned to the patient procedure and diagnosis codesscreen 104, canceling the diagnosis code(s) and specific relatedprocedure code.

If the care provider does not see the proper diagnosis present, the careprovider may select the search option 112 from the diagnosis screen 106.Selecting the search option 112 push button directs the care provider tothe diagnosis search screen 116 as shown in FIG. 15. Here, the careprovider may scan the vast amounts of data representing differentpossible diagnoses. The care provider may search by number or bydescription for the diagnosis codes desired. The care provider thenselects the proper code using either the pen or the on-screen keyboard200. Selecting the OK option push button returns the care provider tothe patient procedure and diagnosis screen 104 with the desired input.Selecting the cancel option push button discards all input and simplyreturns the care-provider to the procedure and diagnosis screen 104. Ahelp push button is also provided should the care provider needassistance.

From the procedure and diagnosis screen 104, the care provider mayselect the ailment option. This directs the care provider to the ailmentscreen 118 as shown in FIG. 16. Here the ailment may be documentedthrough the use of various text boxes labeled to show all the requiredfields for insurance processing including when symptoms first appeared,when the first consultation was sought, etc. The dates will default tothe current day's date unless changed.

Further, the doctor who referred the patient with the respective ailmentis shown including the doctor's name and referring provider number.These may be edited by using the change referring provider option 120.Upon selecting the change referring provider option 120 push button, thecare provider is directed to the referring provider list screen, asshown in FIG. 17. This allows the care provider to select the referringprovider from the list or type in the first letter of the name to narrowthe search using the on-screen keyboard 200. Additionally, if thereferring provider information is to be left blank, the care providercan delete any name listed in the text boxes by selecting the deletereferring provider option 122 push button, which simply clears all textboxes relating to the referring provider. Selecting the OK option sendsthe care provider back to the patient procedures and diagnosis codesscreen 104. A cancel option push button returns the care provider to thepatient selection screen 48. Additionally, a help option push buttonprovides help if the care provider needs assistance.

The patient procedures and diagnosis codes screen 104 also includes anote option 124. By selecting this note option 124 push button, the careprovider is directed to a note option 124 screen as shown in FIG. 18.Here the care provider may use the built in on-screen keyboard 200 orthe pen via handwriting recognition software to enter notes for thisparticular patient into the text box. Again, the on screen keyboard 200is always present on any screen where it is necessary for the careprovider to enter or edit. After entering a note into the text box, thecare provider may select the OK option 126, the cancel option 128, orthe help option 130. Selecting either the OK option 126 or the canceloption 128 will return the care provider to the patient procedures anddiagnosis codes screen 104. Selecting the help option 130 will offerhelp to the care provider.

Also on the patient procedures and diagnosis codes screen 104, is asummary area 140. The summary area 140 contains all procedures selectedalong with the modifiers, units, and diagnosis codes selected whichcorrespond to each procedure. Selected procedures and their accompanyinginformation may be deleted by using the delete option 150 push button. AHelp button (not shown) is also provided.

Modifiers, adding further clarification to the procedures performed, maybe added by clicking on the modifier option 142 push button. Uponclicking on the modifier option 142 push button, the care provider isdirected to the modifier option 142 screen, as shown in FIG. 19. On themodifier option 142 screen, the care provider is presented with a listof possible modifiers relevant to the selected procedure. From thislist, the care provider selects any and all necessary modifiers (up tothree, as allowed by the Health Care Financing Administration). The careprovider may move the selected modifier up, down, to the top or bottomusing the corresponding option push buttons. Additionally, the careprovider may delete either the selected modifier or all of the modifiersusing the delete push button or the delete all push button respectively.Upon conclusion, the care provider clicks on the OK option push buttonor the cancel option push button and returns to the patient proceduresand diagnosis codes screen 104 with or without the desired modifier(s)selected respectively. Further, a help option is available to the careprovider in the need of assistance.

By selecting the units option 144 and clicking on the units option 144push button, the care provider is directed to the units option 144screen as shown in FIG. 20. On the units option 144 screen, the careprovider may enter the number of units desired in the corresponding textbox. The default number of units is one. Further, the care provider mayenter other information, such as the start time, end time, actualminutes, supervisor reduction percentage, etc. in corresponding textboxes through either the pen or the on-screen keyboard 200. Uponconclusion, the care provider clicks on the OK option push button or thecancel option push button and returns to the patient procedures anddiagnosis codes screen 104 with or without the desired units selectedrespectively. Further, a help option is available to the care providerin the need of assistance.

Finally, the summary area 140 also includes a send beam option 146 andan accept beam option 148. The send beam option will transmit only thedata in the summary area 140 to only another computer which is waitingfor the data. Any other computer capable of accepting data is capable ofreceiving data from the send beam option 146 and must be “Accept beam”mode, waiting for data transmission. As only the data in the summaryarea 140, which includes no patient names nor identifying informationwill be transmitted, total patient privacy is ensured. Only anothercomputer which is specifically waiting for data regarding a particularpatient will be able to make use of the data. This situation occursoften between doctors who must rely on the work done just previously byanother care provider. To comply with insurance and governmentalregulations, doctors must include all coding for all prior proceduresperformed on a particular patient.

In order to be waiting for data from another computer, or if anothercomputer is transmitting the data, the front-end computer 14 of thepresent invention, must click on the accept beam option 148. This allowsthe front-end computer 14 to receive data from another front-endcomputer using a non similar back-end link system. Should an erroroccur, an error message appears indicating the error.

Both the send beam option 146 and the accept beam option 148 use awireless linkage, such as the Proxim RangeLAN2 system. Other wirelesslinkage are possible, such as an Infra red laser diode system, such ascurrently found in the art. Further, the linkage may be hardwired totransmit data between two corresponding ports on the front-end computers14.

If the transmission is successful, an “OK” message will appearindicating to the care provider that data has been transmitted. At anypoint in the process, the care provider may wish to terminatetransmission and may exit the beam data option. If the transmissionencounters errors, an appropriate error message is noted. Upon exitingor encountering an error message, the care provider will be passed backto the summary area 140.

From the main menu screen 34, the care provider may also view today'spatient summary 38. This directs the care provider to the patientsummary 64 screen which may be printed, stored, or downloaded from theback-end computer 12. The patient summary 64 screen as shown in FIG. 21,shows a list of all patients seen and processed for the current day. Thelist displays the account number, the patient name, the date of service,all codes that have been posted, the procedure code with modifiers andunits, the first diagnosis code, the care provider number and the dollaramount of charges due per procedure performed.

From the main menu 34, a care provider can select the import data option40. The care provider is directed to the import data screen 166 as shownin FIG. 22. The import data screen 166 includes several check boxesallowing the care provider to decide which files to import. The careprovider may import the patient files, the procedure code files, thediagnosis codes files, the modifiers files, the referring providersfiles, or the facility files, or all of the above. By pressing the penor using a mouse, the care provider may select or check the appropriateboxes. Upon pressing the import option 168 push button and using theprogram link 106, the care provider can import all of the desired filesfor the day. Only the patient files corresponding to the patients thecare provider plans on seeing that day are available. Should the careprovider wish to cancel the import process at any time, the careprovider may click on or press the cancel option 170 push button whichwill cancel the operation. Should the import option 168 fail for anyreason, an error message appears. The care provider is also providedwith a help option 172 to provide assistance if needed.

The main menu screen 34 also allows the user to select the tools andutilities option 42. Upon clicking the tools and utilities option 42push button, the user is directed to re-enter their password as shown inFIG. 23. After confirmation by the system 10, the user is directed tothe tools and utilities 42 screen, as shown in FIG. 24 or a full Toolsand Utilities screen FIG. 25 by entering a special password. The careprovider is presented with the options to view the practice data or theset-up screen or, if password allowed, edit the practice data, selectthe color preferences, or enter the setup screens. One can exit withcorresponding push buttons.

Clicking on the view practice data option 68 push button directs thecare provider to the view practice data option 68 screen, as shown inFIG. 26. This presents the care provider with filled in text boxesallowing the care provider to see the practice name, address, city,state, serial number, license information, type of practice, providernumber, password, identification, and view the selections madeconcerning various options such as repeatability of diagnosis onprocedures, whether to show the start/end times and whether to use thesupervisor reduction percentage. Once the care provider is done viewingthe practice data, the care provider may return to the main menu byselecting the cancel option 176.

Clicking on the edit practice data option 70 push button directs thecare provider to the edit practice data option 70 screen, as shown inFIG. 6. This screen allows the care provider to change any of theinformation listed in the view practice data option 68 screen. After theappropriate information is entered via the keyboard 200 or the pen, thecare provider selects the OK option 178. If the care provider does notwant to keep any changes made, the care provider may select the canceloption 180 and return to the main menu 34.

Clicking on the color preferences option 72 directs the care provider tothe color preferences option 72 screen, as shown in FIG. 27. Here thecare provider may alter the colors used on the screen displays to suitthe individual care provider's preferences. The color preferences may besaved by selecting the save colors option 182, or any changes may becancelled by selecting the cancel option 184. The care provider mayreturn to their previously established colors by selecting the userdefaults option 186 or return to the pre-programmed colors by selectingthe program defaults 190. Here the aesthetics of the front-end computer14 screen may be adjusted to fit the individual care provider'spreferences, fully taking into account human abilities or inabilities todifferentiate between colors—e.g. red and green in red/green colorblindusers. A help option 192 is also provided should the care provider needassistance.

Again referring to FIG. 24, clicking on the setup screens option 74 pushbutton directs the user to the set up screens option 74 screen, as shownin FIG. 28. Here the care provider may alter the setup of the procedurecodes via the procedure code setup option 194 or the diagnosis codesetup option 210.

Clicking on the procedure code setup option 194 push button directs thecare provider to the procedure code screen builder screen as shown inFIG. 29. Here, the care provider may search for codes by number ordescription, select the appropriate code, delete a current code, or adda new code. To import the current CPT/EM codes into the editing area,the care provider may click on the load CPTs option push button. Afterany and all modifications are done, the care provider can click on thesave CPTs option push button. When all modifications are done the careprovider may exit by clicking on the exit option 196 push button. Thisgives the care provider the ability to customize the procedure codesused most frequently for their individual practice. Additionally, helpis available to the care provider via the help option 198.

The diagnosis code setup option 210 and screen, as shown in FIG. 30,works exactly like the procedure code setup option 194, except, ofcourse, with diagnosis codes.

Again referring to FIG. 25, the care provider may exit the tools andutilities option 42 screen by selecting the exit option 76. This returnsthe care provider to the main menu 34.

Now referring to FIG. 3 from the main menu 34, the care provider mayselect the about program option 44. Upon clicking on the about programoption 54 push button, the about program option 54 screen is displayedas shown in FIG. 31. The screen displays the author of the program, theauthor's address and phone number, as well as the current version of theprogram. Once the care provider is done viewing this information, thecare provider may return to the main menu 34 by selecting the OK option218.

Once the care provider is finished using the front-end system 10, thecare provider may log off using the log off option 46 from the main menu34 as shown in FIG. 7. After logging off, the care provider exits thesystem 10 via exit 32.

The system 10 and program described above may be easily modified to workin other health care fields, such as dentistry and non-health carerelated fields such as accounting, law, architecture and others. Anyonein the multiple service industries could use the present invention fortheir billing and records system 10. For example, a law office, whichbases its billing typically on a time standard, could easily use such asystem 10. Instead of diagnosis codes, the law office would be able touse or codify commonly performed task categories, such as “telephoneconversation,” “briefing,” “motion,” “letter,” “trial,” etc. Thesecategories could then have more specific sub categories. For instance,the category “motion” could have subcategories such as “summaryjudgment,” “bifurcation,” “compel,” or as many others as should bedesirable.

Much like the health care industry, more and more legal fees, such ascourt fees, administrative practice fees, etc. are constantly changing.Through the use of this billing/records system 10, a law office may haveone person which can update all appropriate fees for the entire office.Simple modifications would be all that is required. Instead of patients,clients would be selected. Instead of referring physician, referenceattorney or referring entity would be used. These and many othersubstitutions could be made to tailor the program to fit the needs of alaw office. Similar modifications could be made to the program for usein an accounting office, insurance company, brokerage firm, or any othermember of the multiple service industries doing business.

A general description of the present invention as well as a preferredembodiment of the present invention has been set forth above. Thoseskilled in the art to which the present invention pertains willrecognize and be able to practice additional variations in the methodsand systems described which fall within the teachings of this invention.Accordingly, all such modifications and additions are deemed to bewithin the scope of the invention which is to be limited only by theclaims appended hereto.

1-83. (canceled)
 84. A method for providing medical, coding comprising:receiving a selection of a patient procedure code on a first computer;receiving a selection of at least one diagnosis code on the firstcomputer; linking the selection of the patient procedure code to theselection of the at least one diagnosis code on the first computer;storing a relationship defined by the linking wherein the relationshipincludes rank ordering of the selection of the at least one diagnosiscode linked to the selection of the patient procedure code.
 85. Themethod of claim 84 further comprising electronically sending patientdata including the patient procedure code and the linked at least onediagnosis code from the first computer to a second computer.
 86. Themethod of claim 85 further comprising displaying the patient procedurecode and the linked at least one diagnosis code on a display of thefirst computer prior to the step of electronically sending.
 87. Themethod of claim 85 further comprising generating a patient bill at thesecond computer, the patient bill associated with the patient data. 88.The method of claim 84 further comprising associating the patientprocedure code and the linked at least one diagnosis code with patientdata including patient identifying information.
 89. The method of claim84 further comprising sending patient data, including patientidentifying information to the first computer from a second computerprior to the steps of receiving a selection of a patient procedure codeand receiving a selection of a diagnosis code. 90-91. (canceled)
 92. Amethod for providing code-driven medical reporting, comprising:receiving a selection of at least one diagnosis code on a firstcomputer; receiving a selection of a patient procedure code on the firstcomputer; linking the at least one diagnosis code in rank order to thepatient procedure code such that a defined relationship between thepatient procedure code and the at least one diagnosis code ismaintained.
 93. The method of claim 92 further comprising generating abill based on the patient procedure code and the at least one diagnosiscode.
 94. The method of claim 84 further comprising generating a patientbill based on the selection of the patient procedure code and theselection of the at least one diagnosis code.
 95. The method of claim 84wherein the step of linking maintains the defined relationship betweenthe patient procedure code and the at least one diagnosis code.
 96. Themethod of claim 84 wherein the step of linking maintains a record of thedefined relationship between the patient procedure code and the at leastone diagnosis code.
 97. The method of claim 84 wherein the definedrelationship is a care provider defined relationship.
 98. A method forproviding code-driven medical reporting for billing purposes,comprising: receiving a selection of a patient procedure code on a firstcomputer; receiving a selection of at least one diagnosis code on thefirst computer; linking the selection of the patient procedure code tothe selection of the at least one diagnosis code on the first computer,wherein the linking of the selection of the patient procedure code andthe selection of the at least one diagnosis code provides formaintaining a rank ordered relationship between the patient procedurecode and the at least one diagnosis code to thereby provide a detailedrecord of an encounter.
 99. The method of claim 97 wherein each of theat least one diagnosis code is an ICD-9 code.
 100. The method of claim97 wherein the patient procedure code is a CPT code.
 101. The method ofclaim 97 wherein the patient procedure code is an Evaluation andManagement code.
 102. The method of claim 97 wherein a modifier isassociated with the patient procedure code.
 103. The method of claim 97wherein a unit value is assigned to the patient procedure code.
 104. Themethod of claim 97 wherein a time value is assigned to the patientprocedure code.